3.6: Psychological Aids to Weight Control

Because emotions can affect how much we eat, influencing emotions can be an important factor in weight reduction. The theory is good, but it’s as hard to carry out as the simple injunction to “eat less and exercise more.”

We’ve noted that the use of food to deal with emotional stress is instilled very early, and early psychological imprintings run deep. This helps explain why traditional psychotherapy may or may not be successful in motivating patients to control their eating.

If deeply rooted “oral” personality patterns can be dealt with—powerful tendencies to depend on nurturing situations and relationships as ways of dealing with pain or fear —the patient doesn’t need to rely so much on eating or drinking to manage stress.

Psychiatrists have observed that some patients have mixed feelings about their weight, and mixed perceptions of themselves. Some patients who lose large amounts of weight become seriously depressed and anxious. Many continue to think of themselves as “fat people.”

Attempts to make such basic changes in psychological orientation and function are both costly and time-consuming. Therefore, there have been many efforts to find more practical short-term routes to deal with obesity.

Using Group Support

One route uses the psychological pressures of the group—in club-like meetings of the overweight. Principles of dieting and nutrition may be taught to these groups, sometimes rather thoroughly, sometimes in a limited way. Such programs vary widely in quality.

But for all of them, the approval-disapproval power of a group of peers and the sharing of common problems is an important part. Having to pay to participate is also an added incentive to lose weight. But all too often, as soon as the participants are out of the group, they flounder. The situation can be much like children who behave very differently when their parents aren’t watching.

Behavior Modification

Another route tends to be labeled loosely with the popular term “behavior modification.” The term itself is, of course, a very broad one. In a sense, anything we teach people about nutrition is intended to change behavior for the better.

Behavior modification usually refers to a special kind of training, using various techniques to alter eating habits. Originally it began with the theories attributed to the social scientist B.F. Skinner, in which desirable behavior is rewarded and undesirable behavior is punished. As it developed, it dealt with issues like food cues, individual patterns of eating, and rewards and reinforcements for not overeating.

One focus of behavior modification is to increase awareness of food and the act of eating—to make it a more conscious act. Subjects might be taught to count bites of food, with the aim of reducing the number of bites taken each day, so that eating isn’t a kind of blind, unthinking behavior.

A basic feature of such programs is recordkeeping: Where, and under what circumstances did each eating episode take place? Participants learn to track the places they eat, and to avoid places like the couch in front of the television, that foster automatic, unconscious eating. Again, the aim is to teach a greater awareness of one’s eating habits.

After several years of trial and error, the fact remains that in terms of long-term success, some weight-loss programs that use behavior modification techniques have achieved better results than have more traditional methods. Increasingly, specific behavior modification techniques have been incorporated in weight management programs, along with more traditional counseling on diet and exercise.

Obesity can be likened to a lifelong problem—a vulnerability that can be controlled, but for which there’s no “cure.” People who would lose weight in a nutritionally and medically sound way, must accept the truth that they have to eat fewer calories and/or be more physically active. They must understand the insurmountable facts of energy balance. They must be able to compare nutritive values as well as calorie counts. And they must make permanent changes in their dietary and/ or exercise habits. In the long run, shortcuts are likely to only be self-deceptions.